Supporting Value-Based and Integrated Care Models for Parkinson’s Disease

Background

Individuals with Parkinson’s Disease (PD) face uneven and limited access to comprehensive, integrated care models and therapies. However, achieving comprehensive delivery models for individuals with PD is challenging in today’s health care environment. The predominant fee-for-service (FFS) reimbursement model does not adequately compensate providers to furnish all the needed elements of ongoing care, with inconsistent coverage for critical activities like care coordination. Additionally, FFS reimbursement models are not likely to fully account for disease-modifying treatments that are meant to show long-term benefits and do not incentivize developing the post-market evidence required to support coverage and widespread, appropriate use of these therapies.

Value-based payment models for care delivery have the potential to overcome these challenges by providing flexibility to tailor health and health-related services to the unique needs of the individual. By aligning reimbursement with the quality of care delivered and the value of therapies based on real-world evidence, VBP models create a mechanism for health providers to take on responsibility for managing an individual’s health and social needs across the duration of care. This enables health systems to better integrate and coordinate services and invest in traditionally undercompensated activities like continuous monitoring, ongoing care planning, and caregiver support. Additionally, in VBP arrangements like population-based models, providers are encouraged to achieve individual therapeutic goals across the different stages of PD, from early onset to managing care in advanced disease stages. Although VBP models have been developed for populations with advanced serious illness, existing models have not specifically focused on individuals with PD, whose complex health and social needs can require additional resources.

Project Overview

This project seeks to identify new ways of delivering and paying for care and medical products to ensure individuals with PD have access to high-quality medical and non-medical services aligned with the intensity of care they need. The project will develop recommendations for adjusting payment models and policies to better support high-value care for individuals with PD. Key activities include identifying how delivery organizations participating in such payment models would redesign care, integrating new therapies, and understanding the practical challenges of switching to new payment models.

Funding

This project is supported by a grant from The Michael J. Fox Foundation.